TEXAS CHILDREN’S CANCER AND HEMATOLOGY CENTERS

Experts in childhood cancer and blood disorders

With a staff of renowned experts in the treatment and research ofpediatric and adolescent cancer as well as hematologic disorders,we have developed a wide array of programs aimed at curingchildren with diagnoses ranging from the most common to thevery rare.

• Pediatric and adolescent cancer and hematology programs include:

– Bone marrow failure

– Bone marrow transplantation

– Bone tumor

– Brain tumor

– Cancer genetics and genomics

– Childhood cancer epidemiology and prevention

– Developmental therapeutics

– Ewing sarcoma

– General hematology (anemias, thalassemia and others)

– Hemostasis and thrombosis (bleeding and clotting)

– Histiocytosis

– Immune hematology

– Leukemia

– Liver tumor

– Long term survivor

– Lymphoma

– Neuroblastoma

– Palliative care

– Precision oncology

– Rare tumors

– Retinoblastoma

– Solid tumor

– Thyroid cancer

– Vascular anomalies

Working as a team to cure kids

Treatment is organized around diagnosis-specific multidisciplinarytreatment teams comprised of physicians, nurse practitioners,nurses, social workers, pharmacists and child life specialists. Allpatients have their own primary physician who oversees theircare. Patients are seen by the same doctors, nurses and socialworkers on an ongoing basis to provide a sense of trust, safety

and comfort. Patients receive the highest standard of treatmentfor their disease because they are cared for by an entire teamof experts rather than a single doctor. All our physicians areboard-certified in pediatric oncology and hematology.

Groundbreaking research and innovative therapies

As a recognized research leader in the fields of pediatric hematology and oncology, we translate breakthrough findingsfrom the laboratory into the clinic.

We are currently conducting over 200 clinicaltrials – more than any other center in the nation.

Our Developmental Therapeutics and Clinical PharmacologyProgram has been a leader in the study of novel agents for thetreatment of cancer and hematologic disorders. Our vast expertisein the development of new therapeutics means our patientshave access to the most advanced and innovative therapies.

As the largest pediatric cancer and hematology centers in the United States, we provide individualized state-of-the-art medical treatment for patients with childhood cancer and blooddisorders. We are consistently rated one of the top programs for pediatric cancer treatment byU.S.News & World Report.


Leading the fight against childhood cancer

Our physicians employ evidence-based guidelines and the mostadvanced clinical trials in the delivery of hematology and oncologycare. For example, recognizing that clinical trials are the standardof care for all children with cancer, every eligible patient is considered for entry on National Cancer Institute-approvedclinical trials. Approximately 80 percent of our patients are registered in these studies. These treatment studies representleading therapies in the field to provide the best treatments forchildren with cancer.

Working as a partner with community physicians

Our physicians and staff work extremely closely with referringphysicians. We maintain excellent communications with patients’referring physicians to ensure that care delivery is seamless.

Continuity of care

Because we work so closely with our patients’ referring physicians,we are able to maintain excellent continuity of care. This is wellillustrated by our approach to cancer survivors. During the past60 years, pediatric oncologists have made great strides in improvingthe overall cure rate of children with cancer. Approximately 80percent of children diagnosed with cancer now survive – and thisrate is likely to improve in the coming years. There are currentlymore than 350,000 childhood cancer survivors in the UnitedStates. Because child and young adult cancer survivors are at riskfor serious medical problems that result from their illness or itstreatment, Texas Children’s Cancer Center is in contact witheach of its survivors on a yearly basis.

In addition, we have developed on online application called Passportfor Care®, which is an Internet-based decision support tool usedin more than 125 children’s cancer clinics in the U.S. and several

foreign countries. Passport for Care gives the

survivors and their health care providers accessto their treatment information and guidelinesfor screening for potential late effects ofchildhood cancer treatment in order to improvetheir long term health and quality of life.

Passport for Care is a major component of ourLong Term Survivor Program, which monitorspatients for delayed side effects and complications caused by previous cancer therapies. These late effects are potentially serious and often subtle and difficult to diagnose. Our Long Term Survivor Programhas developed an international reputation as a leader in the field and has attracted a world-renowned faculty involved in local, national andinternational research that benefits today’s pediatric cancer patients and future survivors.

Healing the whole child, supporting the family

Our commitment to the whole child and familystarts at the time of diagnosis and continuesthroughout treatment and beyond. The diagnosisand treatment of a childhood cancer or blooddisorder presents extraordinary psychological,emotional and social challenges to the entirefamily.Texas Children’s Cancer and HematologyCenters offer a variety of services throughour Psychosocial Support Program. This helpspatients and families adapt and mobilize theirresources in the battle against these diseases.

All patients and their families have access topersonal counseling. In addition, each patientand family is assigned a social worker to help them navigate successfully through their disease experience.

At the heart of these services isthe personal commitment of everymultidisciplinary team memberto understand each young patientas a unique individual. Teammembers also collaborate withparents at each step in the processto be attentive to the quality of life of all family members, including siblings.

We also offer a Supportive Help for AccessingResources and Education (SHARE) Deskwhere families can obtain information or access resources that are available at TexasChildren’s Cancer and Hematology Centersas well as throughout the community. The SHARE Desk is located centrally withinthe registration area and is available to all patient families.

Texas Children’s Cancer and HematologyCenters also offer palliative care for seriouslyill children. Our Palliative Care Team helps patients feel more comfortable by interveningto improve their quality of life. The team addresses symptoms such as pain, fatigue andnausea as well as helps assuage feelings of anxiety or depression. Palliative care can begiven in addition to current treatment for anillness or on its own, and has been shown tohave positive physical and emotional benefits.

In addition to child life services, educationprograms, social workers, teen retreats, financialaid, hotels and housing, internet resources, painmanagement and palliative care, our programsfor psychosocial support and education also

include an Arts in Medicine (AIM) Program

that provides educational and artistic opportunities for patients designed to helpheal the whole child. Activities of our AIMProgram include dance and musical theatreproductions, art projects, songwriting, culturaldance, acting, writing and more.

Another example of a novel supportive careprogram is Purple Songs Can Fly, which providesa unique opportunity for patients and theirsiblings to work with professional composersand musicians to write and record their own songs. Through a highly creative, musical environment many children are better able toexpress the many and varied thoughts andfeelings that emerge during treatment. ThroughPurple Songs Can Fly, children are able to sharetheir music with friends and family in the formof individual CD recordings of their songs.

Our patients may also have the opportunity toattend several activity camps. Camp Periwinkleis a week-long summer camp that allows timeaway from a hospital setting and gives patientsthe chance to experience the joys of childhoodin a healthy environment. In addition, we supportpatients who go to Camp YOLO (You OnlyLive Once), a twice a year special weekendcamp for teenage cancer patients to enjoy theoutdoor lifestyle with their physicians, nursesand members of their support team. Selectedpatients also gather yearly at Grand Teton National Park in Jackson Hole, Wyoming forthe Grand Adventure at Teton Science Camp,where they are educated and trained aboutnature in a beautiful landscape rich with wildlifeand breathtaking views.

The International Center

Our International Center is dedicated to thecare and treatment of pediatric hematologyand cancer worldwide. In a world where 80% ofchildren with cancer in industrialized countriesare cured and 90% of children with cancer in sub-Saharan Africa die, we are making a difference. We provide direct care and treatmentfor children with cancer in Botswana, Malawiand Uganda. In the area of hematology, we areconducting neonatal sickle cell screening andproviding care and treatment for sickle celldisease in Angola. Simultaneously, we train localnurses and doctors in these locations, buildingskills and leadership for pediatric hematology-oncology programs in these countries. Wealso provide consultation to local physicians inLesotho, Swaziland and Tanzania for childrenwith HIV-related cancer and blood disorders.

Outpatient facilities

Our child-friendly, state-of-the-art outpatientclinic is located on the 14th floor of the ClinicalCare Center, the ambulatory care building ofTexas Children’s Hospital. To help patients feelat home, the clinic has waiting areas, play areas,The Johnny Klevenhagen Family EducationRoom and the Joan and Stanford AlexanderLearning Center. Activities such as arts andcrafts, videos and computer games are available.

The clinic conducts over 73,700outpatient visits per year withpatients that have traveled from more than 35 states and 26 countries.

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Our facilities

Inpatient facilities

The Texas Children’s Cancer and HematologyCenters’ 36-bed unit is located on the 9thfloor of Texas Children’s Hospital’s WestTower. The inpatient rooms are family-friendlyand use the latest pediatric technological advances. Some of the other amenities ofWest Tower include a family services floorfeaturing pre-teen and teen activity rooms, abusiness center, library and classrooms; familyrooms located on each patient-care floor designed as a respite for parents and families;and large patient rooms, approximately 330square feet in size.

Bone Marrow and Stem CellTransplant Unit

Our 15-bed Bone Marrow and Stem Cell

Transplant Unit is located on the 8th floor ofWest Tower. It is the largest of its kind in thesouthwestern United States. The inpatienttransplant unit is uniquely designed with children’s needs in mind. A specialized high efficiency particulate air (HEPA) air-filtrationsystem allows children to safely leave theirrooms and roam freely in the unit.

Bone Marrow TransplantOutpatient Clinic

The Bone Marrow Transplant Outpatient Clinicis located adjacent to the Bone Marrow Transplant inpatient unit, and the service is accredited by the Foundation for the Accreditation of Cellular Therapy. The clinicprovides diagnosis, treatment and follow-upcare of patients who are in need of or havereceived a hematopoietic stem cell transplant.

There are six exam rooms, two of which are

equipped with negative pressure airflow andsix infusion bays. The dedicated nursing staff isfully cross-trained for inpatient and outpatientservices.

Texas Children’s Hospital West Campus

In 2011, Texas Children’s Hospital opened acommunity hospital located on 55 acres inKaty, Texas near I-10 and Barker Cypress. The515,007-square-foot hospital houses the only24/7 pediatric emergency room in the GreaterWest Houston area. Hematology and oncologyservices are available at Texas Children’s Hospital West Campus. If you are interested,please follow our standard referral process andask your attending physician about availabilityat West Campus.

The Feigin Center for Research

Texas Children’s Cancer and HematologyCenters are national and international leadersin clinical and basic research. The centers arecomponents of the Pediatric Hematology-Oncology Section of the Department of Pediatrics at Baylor College of Medicine. We have over 350 researchers and staff in 42 different research laboratories performingcutting-edge research. These laboratories arehoused in the Feigin Center building at TexasChildren’s Hospital. This $40 million recentlyexpanded and renovated state-of-the-art research facility now offers research and office space to our physicians and scientistswho lead innovative pediatric cancer andhematology research initiatives.

Referrals

During business hours (Monday to Friday 8 a.m. to 5 p.m.):

Physicians referring oncology patients may call 832-822-4242 or 1-800-226-2379.

Physicians referring hematology patients may call 832-822-4362 or 1-855-824-2972.

The clinic coordinator will immediately transfer the referring physician to one of our attending physicians.

During non-business hours, weekends and holidays:

Referring physicians may call the Texas Children’s Hospital operator at 832-824-1000 and ask for the oncology or hematology fellow on call.

Contact us

Texas Children’s HospitalCancer and Hematology CentersClinical Care Center, 14th floor6701 Fannin St.Houston, TX 77030-2399

txch.org

OncologyPhysicians and families: 832-822-4242

1-800-CANCER9(1-800-226-2379)

HematologyPhysicians and families: 832-822-4362

1-855-824-2972

International referrals

Appointments for patients from outside the United States are made through Texas Children’s International Services. International Services will connect the referring provider withone of the physicians at Texas Children’s Cancer or HematologyCenters. Next, the family will be asked to call Texas Children’sInternational Services to make an appointment.

832-824-1138 or 1-888-240-8244Toll-free number from Mexico: 01-866-643-5339

Para mayor información desde México, favor use nuestro numero de teléfono libre de costo: 01-866-643-5339

As part of Texas Children’s Hematology Center, the Bone MarrowFailure Program diagnoses and treats patients for a variety ofconditions contributing to bone marrow failure. Some of theconditions we treat include:

• Acquired aplastic anemia, including hepatitis-associated• Barth syndrome• Congenital amegakaryocytic thrombocytopenia• Diamond Blackfan anemia• Dyskeratosis congenita• Fanconi anemia• Myelodysplastic syndrome• Myelofibrosis• RUNX1 deficiency syndrome• Severe congenital neutropenia (Kostmann syndrome)• Shwachman Diamond syndrome• Thrombocytopenia-absent radius syndrome

Our clinicians perform bone marrow aspirations and biopsies,make genetic and molecular diagnoses, offer immunosuppressivetherapy for patients with acquired aplastic anemia, coordinatecomprehensive expert multidisciplinary care for patients withinherited bone marrow failure syndromes and, if necessary,make referrals to our expert Bone Marrow and Stem CellTransplant Program.

ResearchOur program was recently awarded a Department of DefenseCongressionally Directed Medical Research Program Exploration-Hypothesis Award in the area of bone marrow failure and receivedan award from the Cancer Prevention Research Institute of Texas.This research is part of our larger efforts to uncover new pathwaysand molecular mechanisms contributing to bone marrow failurein children.

ReferralsPhysicians and families may call the Bone Marrow Failure Programat 832-822-4362 or 1-855-824-2972.


Bone Marrow Failure Program

This award-winning program joins innovative research with top clinical care and support toaddress conditions contributing to bone marrow failure.

Bone marrow transplantation as treatment For some time, bone marrow transplantation has been thetreatment of choice for relapsed leukemia patients. However, therole of bone marrow transplantation in the treatment of childrenwith other forms of cancer, blood diseases and genetic disordersof immunology and metabolism has increased dramatically in thelast few years. The Bone Marrow and Stem Cell Transplant Program is expanding the use of this technique for patients withsolid tumors including neuroblastoma and brain tumors; a variety of high-risk hematologic diseases, such as thalassemiamajor and transfusion-dependent sickle cell disease; and other nonmalignant diseases.

In addition, the Cell and Gene Therapy (CAGT) Program at TexasChildren’s Hospital, Baylor College of Medicine and The MethodistHospital helps rapidly translate novel cell and gene therapy protocolsfrom the laboratory to the clinic. In particular,Texas Children’s isable to make genetic and molecular diagnoses in conjunctionwith the CAGT Program, as well as administer cell-based therapies.

Patient comfortAs patient comfort is a priority, we employ new approaches to carethat provide patients with more mobility and access to activitiesduring their stay.A specialized high-efficiency particulate air

(HEPA) filtration system allows patients to leave their rooms andparticipate in social functions on the unit.

High rate of donor matchesWe have virtually 100 percent success finding a donor for everypatient needing stem cell transplantation. If a perfect match isunavailable, we are able to perform cord blood transplants oruse donors other than perfectly matched siblings, such as parents.One of our main goals is to consistently expand our donor pool inorder to provide patients the best possible transplantation options.

ResearchAs one of the top programs for cell-based therapies, our researchfocuses on improving transplantation outcomes by reducing oravoiding infection or relapses.Another component of our researchlooks at viral-specific cells to see how we can ensure patients’cells have short and long term immunity.

ReferralsReferring physicians may call the Bone Marrow and Stem CellTransplant Program at 832-822-4242 or 1-800-226-2379.


Bone Marrow and Stem Cell Transplant Program

Texas Children’s Cancer Center is a premier bone marrow and stem cell transplantation program.Our state-of-the-art, 15-bed inpatient transplant unit is among the largest of its kind in theUnited States and focuses exclusively on transplantation.

Our team of experts in pediatric bone tumors includes pediatriconcologists, orthopedic oncologic surgeons, physical therapists,pediatric pathologists, musculoskeletal radiologists, pediatricnurses, social workers and child life specialists. This team approach enables patients and families to receive the most comprehensive and innovative care in a single location over thefull course of their treatment and follow-up.

Evaluation and treatmentPatients with bone lesions, whether suspected or known to bemalignant, receive initial evaluation in our multidisciplinary Musculoskeletal Tumor Clinic, where they are seen by both a pediatric oncologist and an orthopedic oncology surgeon. Patients with malignant bone tumors will receive care and treatment from this unique team of providers at Texas Children’sCancer Center; patients with benign bone tumors receive follow-up care from the Orthopedic Division at Texas Children’sHospital. Modalities of treatment used to treat malignant bonetumors may include surgery, chemotherapy, radiation therapy and/or immunotherapy.

ResearchTexas Children’s Cancer Center has the largest and most comprehensive bone tumor research program in the United States.The program is designed to integrate the work of laboratory researchers and translational researchers with clinicians whoare directly involved in the care of patients with bone tumors.The common goal is to discover more effective, less toxictreatments for bone tumor patients.

Bone tumor research investigators have ongoing studies focusedon understanding the pathogenesis, biology and malignant determinants of bone tumors.A major aim is to develop novelapproaches that will prevent the development of metastases.

ReferralsPhysicians and families may call the Bone Tumor Program at832-822-4242 or 1-800-226-2379.


Bone Tumor Program

As one of the largest programs in the country, the Bone Tumor Program at Texas Children’sCancer Center offers multidisciplinary care to patients with bone tumors including osteosarcomaand Ewing sarcoma.

We treat approximately 140 new pediatric brain tumor patientseach year from all over the world, many of whom cannot betreated anywhere else.

Multidisciplinary careMany physicians at Texas Children’s Cancer Center contribute to the care of children with brain tumors. Neurosurgeons, medical and radiation oncologists, neuroradiologists,

neuropathologists and neurologists discuss each newly diagnosedpatient at a weekly conference in order to provide the most appropriate care for each child. Nurse practitioners, nurses,physical and rehabilitation personnel, neuropsychologists, endocrinologists, ophthalmologists, social workers and otherswork closely with the physicians as a team so that all aspects ofcare for a particular child and the family are addressed.

Innovative protocols and therapiesThe Brain Tumor Program develops and participates in nationaland international research studies and clinical trials, allowing us totreat our patients with the latest and most innovative therapies.Our investigators are leaders in the development of new drugs,sophisticated radiotherapy approaches and the application of othernovel approaches to brain tumor therapy.The Texas Children’sCancer Center Developmental Therapeutics Program activelyinvestigates new agents and provides guidance to our physiciansand families on the use of novel brain tumor therapies.

We have also embarked on an innovative journey involving the development of personalized medicine based on genome sequencing of each patient’s tumor.This will enable us to deliver targeted therapies unique to the individual patient withthe potential for greater efficacy and lessened side effects.

In addition, we are a founding member of the Pediatric BrainTumor Consortium (PBTC) and also a member of the Children’sOncology Group (COG). Through PBTC, COG and our institutional clinical trials, our patients have broad access to themost advanced experimental protocols for treatment of theirbrain tumors.

ReferralsPhysicians and families may call us at 832-824-4220 or 1-800-266-2379. We can also be reached by email at [email protected].


Brain Tumor Program

Established in 1993, the Brain Tumor Program at Texas Children’s Cancer Center is one of thelargest of its kind in the country focused on children and adolescents.

Cancer Genetics ClinicFounded in 1995, the Cancer Genetics Clinic offers DNA diagnostic studies, screening tests and counseling services tofamilies at risk of childhood cancer. Led by internationally recognized geneticists working closely with genetic counselors, weprovide comprehensive analysis, physical exams, risk assessments,counseling and risk minimization strategies and recommendationsfor future screenings regarding cancer.

Collaborating with departments across the hospital, the cancergenetics team provides the highest level of analysis and care toour patients and their families. Evaluation results are shared directly with the patient’s physicians to best help guide ongoingcare and management. Decisions about genetic testing for cancersusceptibility genes, when indicated, are made only after discussionswith families.

Childhood Cancer Prevention and Screening ClinicEstablished in July 2012, this clinic provides centralized cancerscreening services for children with hereditary cancer predisposition syndromes and other conditions that increasethe risk of childhood cancer. Our pediatric oncologist developsand implements screening regimens adapted for each childbased on the latest medical literature. Screenings consist of

longitudinal assessments including interviews, physical exams,laboratory testing and imaging. With a dedicated staff, we providethe most effective and up-to-date screening methods available.

ResearchOur Cancer Genetics Clinic participates in most national clinicaltrials and has recently received sizeable grants from Cancer Prevention Research Institute of Texas and the National Institutesof Health to examine how we can use genome-scale sequencingin the care of childhood cancer patients to offer better treatments. Our program also includes research groups whostudy the basic science behind cancer development, constantlyadvancing cancer knowledge.

Referrals We pride ourselves in partnering closely with referring physiciansand families throughout the process to ensure they are fully informed about their patient’s care. Physicians may call our clinicat 832-822-4242 or 1-800-226-2379. Families may contact theCancer Genetics Clinic at 832-824-4685.


Cancer Genetics Clinic and Childhood Cancer Prevention and Screening Clinic

Our goal is to help patients and their family members understand their diagnosis or predisposition for cancer, learn the risks of developing future cancers and recommend and provide screening services for cancer prevention and early detection.

As part of Texas Children’s Cancer Center, the DevelopmentalTherapeutics Program has achieved national recognition as amajor leader in the development of novel chemotherapy approaches to pediatric cancer treatment.

Members of the program include physicians board-certified inpediatric hematology-oncology, clinical pharmacology, hospiceand palliative medicine, as well as post-doctoral fellows, clinicalresearch nurses, nurse practitioners, data managers and laboratoryresearch associates. Program investigators have developed andled numerous national early phase and pharmacokinetic studies,and they also have expertise in pharmacokinetic-pharmacodynamicmodeling including population pharmacokinetics.

We view referring physicians as partners in care, and keep them informed throughout the entire process of referral, evaluation, diagnosis, treatment and follow-up.

Clinical trialsWe participate in every major pediatric oncology and pharmacology cooperative group, providing our patients accessto cutting-edge therapy for pediatric malignancies. Our programis a major contributor to the Children’s Oncology Group (COG)

Phase I Consortium and is the only COG Phase 1 institution inthe southwestern United States. In addition, we are one of onlythree Alex's Lemonade Stand Developmental Therapeutics Centers of Excellence in the nation. As leading researchers, ourphysicians develop nationwide studies for the COG and the Pediatric Brain Tumor Consortium. We also work closely withindustry to make important new agents available for childrenwith cancer.

The Developmental Therapeutics Program offers phase 1 andother early phase clinical trials for a wide range of children’scancers.We work closely with referring physicians and familiesto identify appropriate options for each individual child and to support the child and the whole family through the entire treatment process.

ReferralsReferring physicians and families may contact the DevelopmentalTherapeutics Program by calling 832-824-4570 or 1-800-226-2379.


Developmental Therapeutics Program

Founded in 1994, the Developmental Therapeutics Program focuses on the preclinical and clinicaldevelopment of new agents to treat pediatric malignancies.


Faris D. Virani Ewing Sarcoma Center

Evaluation and treatmentAs one of the most challenging forms of cancer to treat, Ewingsarcoma tumors often originate in large bones such as the hip,shin, chest and arm bones. Approximately 250 new cases are diagnosed in the United States per year. As members of theChildren’s Oncology Group, Texas Children’s Cancer Center usesseveral treatment options for children diagnosed with Ewing sarcoma, including chemotherapy, surgery and radiation therapy.

All patients are managed by a multidisciplinary musculoskeletalteam that includes pediatric oncologists, surgeons, pathologists,radiation oncologists, interventional radiologists, physical and occupational therapists, nurses, social workers, child life specialistsand more, who provide care tailored to each patient.

Our experienced orthopedic surgeon uses innovative techniquesto preserve the affected limbs and thereby retain maximal function. One such procedure is a non-invasive limb-lengtheningtechnique, which can be very beneficial to the growing child.

ResearchThe Faris D.Virani Ewing Sarcoma Center has a strong emphasis onresearch.

Our team has several targeted research goals, including developinga greater understanding of:

• Mechanisms that cause cancer cells to travel throughout the body• Stem cells involved in the initiation and development of the tumor• Nutritional and energy requirements for the tumor

cell’s metabolism• Blood-based biomarkers, monitoring the presence of the

disease, response to therapy and even prognosis• The use of immune cells to specifically target and destroy

Ewing sarcoma cells

We perform state-of-the-art basic, translational and clinical research in order to provide transformative and effective treatmentapproaches for the care and management of all patients diagnosedwith Ewing sarcoma.

ReferralsPhysicians and families may call the Faris D. Virani Ewing SarcomaCenter at 1-844-EWINGS1 (394-6471) or 1-800-226-2379.

Part of the Solid Tumor Program, our center is dedicated to research, advancement and treatment of Ewing sarcoma, the second most common bone tumor in children.

Renowned for innovative research and therapies for blood disorders, Texas Children’s Hematology Center physicians conductclinical and scientific research aimed at understanding, preventingand curing blood diseases in children and adolescents.

The Hematology Center offers comprehensive services for theevaluation and treatment of children and adolescents with acuteand chronic blood diseases.

The state-of-the-art, team-based program provides treatmentfor a broad range of clinical ailments including:

• Anemias, thrombocytopenias and neutropenias • Congenital and acquired bleeding disorders • Hemoglobin disorders, including sickle cell anemia and thalassemia • Aplastic anemia and other bone marrow failure syndromes • Hypercoagulation syndromes and thrombotic disorders

The hematology team has developed and implemented a comprehensive series of clinical practice guidelines to ensurepatients receive the best possible care for conditions that includeimmune thrombocytopenic purpura, hemophilia and bleedingdisorders, sickle hemoglobinopathies and lead poisoning.

Texas Children's Hematology Center is dedicated to the integrationof laboratory and clinical research to increase our understandingof blood disorders and to develop new, more effective therapiesfor children who suffer from hematologic malignancies.

ReferralsPhysicians and families may contact the General HematologyProgram by calling 832-822-4362 or 1-855-824-2972.


General Hematology

Our team-based approach provides treatment for a broad range of blood disorders.

We provide comprehensive diagnostic and treatment programs,social services and psychological, dental and orthopedic specialtysupport for the long term evaluation and treatment of childrenwith many conditions, including:

• Heavy menstrual bleeding• Hemophilia• Platelet disorders• Stroke

Our dedicated, multidisciplinary team follows patients bothin the clinic and in the hospital setting. Our AnticoagulationProgram, staffed with pediatric hematologists and hematologynurses, helps patients monitor their often complicated drugtherapy, both in and out of the hospital.

CollaborationsOur team works closely with other leading experts throughoutTexas Children’s Hospital to optimize care of patients withbleeding and clotting disorders.These collaborative efforts incorporate advanced interventional technologies to treat complicated cases of thrombosis and life-threatening bleeding.

Young Women’s Bleeding Disorder ClinicIn collaboration with the Pediatric and Adolescent GynecologyDivision, the Young Women’s Bleeding Disorder Clinic followsand treats patients with heavy menstrual bleeding and bleedingdisorders in a comprehensive and coordinated manner. Ourclinic provides “one-stop” care for gynecologic, hematologic andpsychosocial issues for teenagers.

ResearchRenowned for our research and therapies for blood disorders, weconduct state-of-the-art clinical and scientific research aimed atincreasing our understanding of bleeding and clotting disorders anddeveloping new, more effective therapies for children who sufferfrom them. Our clinical research is focused on novel agents thatincrease safety, convenience and effectiveness of therapy for patients.

Referrals Physicians and families may refer patients to the Hemostasis andThrombosis Program at 832-822-4362 or 1-855-824-2972.


Hemostasis and Thrombosis Program

As one of 134 federally funded hemophilia treatment programs across the country, Texas Children’sHemostasis and Thrombosis Program is part of a national network designed to provide state-of-the-art care to children with congenital bleeding and thrombotic disorders.

• Thrombosis• Von Willebrand disease• Other bleeding or

clotting disorders

Incorporating a large multidisciplinary team, we treat children andadults with the following histiocytic disorders:

• Erdheim Chester disease • Hemophagocytic lymphohistiocytosis• Juvenile xanthogranuloma • Langerhans cell histiocytosis (LCH)• Multifocal reticulohistiocytosis • Rosai Dorfman disease

Multidisciplinary careIn addition to our team of specialists focused on histiocytosis,patients may see neurologists, radiologists, endocrinologists, orthopedic surgeons, pathologists and many other clinical and social specialists in order to receive the best possible care.

ResearchWith the dramatic growth of the Histiocytosis Program, we havedeveloped and expanded the number of clinical trials of innovativetherapies to treat histiocytosis conditions. Our extensive clinicalexperience, coupled with the basic research studies we design

with biopsy and other tissue samples, provides the opportunityfor us to establish clinical and biologic correlations that noother center in the world can. Our research focuses on geneticchanges in cells of the immune system that lead to LCH andrelated disorders.We have built a program to discover thecauses of these conditions in order to expedite developmentof more effective and innovative therapies.

The Histiocytosis Program has several active grants from theNational Cancer Institute, the Histiocytosis Association ofAmerica, the American Society of Hematology and the AmericanSociety for Clinical Oncology.

ReferralsPhysicians and families may make referrals by calling 832-822-4242or 1-800-226-2379.


Histiocytosis Program

One of the largest programs of its kind in the world, the Histiocytosis Program at Texas Children’sCancer Center treats more than 150 new patients each year and follows more than 700 additional patients.

One of the newest programs within the Hematology Center atTexas Children’s Hospital, the Immune Hematology Programspecializes in the treatment of disorders caused by immune destruction of blood cells.

The Immune Hematology Program offers comprehensive, state-of-the-art care, thorough evaluation and diagnosis and access toall standard treatments as well as novel therapies in clinical trials.

Some of the conditions we treat include:

• Autoimmune hemolytic anemia (AIHA) • Immune thrombocytopenia (ITP) including chronic ITP • Neonatal alloimmune thrombocytopenia • Neonatal hemolytic anemia • Thrombotic thrombocytopenic purpura

Our program is unique in that it focuses solely on pediatric immune hematology. Our hematologists are experts in immunehematology and aim to provide the highest level of care available.We regularly provide consultations for local pediatricians andwork closely with patients and families to ensure understandingof the diagnosis and treatment options. We have a comprehensivesupport staff to help with understanding and coping with symptoms.

Multidisciplinary careFollowing the latest guidelines, we offer a full scope of carethrough the experts at Texas Children’s Hematology Center aswell as throughout the 40 subspecialties at Texas Children’sHospital. Working closely with Rheumatology, Immunology, Genetics, Texas Children’s Newborn Center and Pathology, wecarefully monitor patients for development of other immuneproblems now as well as throughout their lives.

ResearchWe are actively researching the causes and treatments of thesedisorders as well as collaborating with leading centers around thecountry to offer our patients the best treatments available. Weare also researching various aspects of ITP diagnosis and therapy.Upcoming projects include development of ITP and AIHA registries to understand the natural history of these disorders in children.

ReferralsPhysicians and families may call the Immune Hematology Programat 832-822-4362 or 1-855-824-2972.


Immune Hematology Program

As one of the only pediatric immune hematology clinics in the country, we treat immune-related blood cell abnormalities through comprehensive, multidisciplinary care.

Our multidisciplinary team of physicians and staff sees patients forinitial treatment and ongoing care. Experts in pediatric oncology,pediatric surgery, cell and gene therapy including stem cell transplant, radiation oncology, pediatric anesthesia, pharmacology,social work, child life and the full complement of pediatric subspecialty services, we put a strong focus on family-centered

care and emotional support for both the child and the family.

Treatment options include chemotherapy, Phase 1 investigationaltherapies, radiation therapy (both conventional and proton),bone marrow transplantation and immunotherapy. Each patientreceives individualized treatment according to his or her diagnosis.

In addition, we have dedicated, state-of-the-art hematology, cytogenetics, flow cytometry and molecular pathology laboratorieswhich conduct comprehensive testing and provide timely andaccurate patient results.

Clinical trialsThe Leukemia Program conducts numerous clinical trials forchildren with newly diagnosed leukemias and for children withrecurrent and resistant disease.All patients are considered foreligibility to participate in clinical trials, which are the standardof care for our patients.The program is unique in its concentrationof nationally and internationally recognized leaders in the areas

of new drug development and cell and gene therapy. We designand conduct both local and national clinical trials through theChildren’s Oncology Group (COG).

Texas Children’s Cancer Center is a member of the COGPhase I Consortium, a small and select group of institutions thatadminister Phase I clinical trials of drugs in early development.

ResearchResearch in the Leukemia Program spans from basic molecularstudies of leukemia biology and immunotherapy to the developmentof novel agents, as well as mitigating the late effects of treatmentin long-term survivors. The Leukemia Program is dedicatedto integrating laboratory and clinical research to increase ourunderstanding of leukemia and to develop new, more effectivetherapies for the disease.

ReferralsPhysicians and families may call the Leukemia Program at 832-822-4242 or 1-800-226-2379.


Leukemia Program

As one of the largest and most comprehensive pediatric leukemia treatment programs in thecountry, we provide diagnosis, evaluation and ongoing management to over 500 pediatric patients with suspected or diagnosed acute lymphoblastic leukemia, acute myeloid leukemiaand chronic leukemias each year.


Liver Tumor Program

The Liver Tumor Program at Texas Children’s Cancer Center provides expert diagnosis and treatment of pediatric liver tumors within a state-of-the-art clinical setting.

The Liver Tumor Program offers comprehensive, multidisciplinarycare to children with any liver tumor including hepatoblastoma,hepatocellular carcinoma, hepatic adenoma, sarcoma of the liverand vascular malformations of the liver. Our center is comprisedof expert pediatric oncologists, liver surgeons, pathologists, radiologists, interventional radiologists, liver transplantation specialists, pharmacologists and geneticists who provide optimalcare to our patients.

We see patients with liver tumors ranging from relatively commonto the extremely rare, making us one of the largest liver tumorprograms in the nation.

TreatmentOur multidisciplinary team of physicians meets regularly to establish the optimal treatment plan for each individual childwith a liver tumor. If a liver transplant is the best course of action, our world-renowned pediatric liver transplant team isimmediately available. Ours is one of the few pediatric livertumor centers in the country to offer transplantation within thesame facility. We also offer advanced interventional radiologytechniques such as transarterial chemoablation and radiofrequency ablation to treat liver lesions, procedures commonly used in adult patients but relatively new in pediatrics.

ResearchThe Liver Tumor Program’s principal areas of research span frombasic science to clinical research, with particular emphasis ontumor biology and the identification of new targets for therapies.

Scientists at Texas Children’s Cancer Center have ongoing studiesfocused on understanding the pathogenesis, biology and malignantdeterminants of liver tumors, developing novel targeted therapiesand immunotherapeutic approaches. These investigations rangefrom molecular genetic studies to novel clinical trials for treatmentof recurrent or refractory disease.

We are working with the Children’s Oncology Group and theChildhood Liver Tumors Strategy Group of the International Society of Pediatric Oncology on an upfront trial for hepatoblastomaas well as new drug trials with the ultimate goal of curing 100 percent of children with liver tumors.

ReferralsPhysicians and families may call the Liver Tumor Program at 832-822-4242 or 1-800-226-2379.

The Long Term Survivor Program has attracted a world-renownedfaculty involved in local, national and international research thatbenefits today's pediatric cancer patients and future survivors.The program sees patients with any childhood cancer diagnosiswho are at least two years after the completion of therapy.

A critically important focus of the Long Term Survivor Programis to provide patient education about diagnosis, treatment andpotential risks (late effects) of prior cancer therapy. There is astrong emphasis on ways to maintain and maximize good healththrough discussions of diet, exercise, environmental exposure and stress.

Comprehensive appointments include evaluation of the patient'sphysical health as well as academic and social development. Additionally, survivors are offered opportunities for enrollmentinto clinical research trials if interested.

Passport for Care®

Texas Children’s Cancer Center, through collaboration withother researchers at Baylor College of Medicine, The Center forCollaborative and Interactive Technologies and the Children’sOncology Group, has developed the Passport for Care (PFC).

PFC is an innovative and interactive internet-based tool for survivors and their care providers that allows increased accessto the survivor’s medical information as well as accurate andtimely individualized health care guidelines for following longterm survivors.

PFC was developed in 2007 to address the health care needs ofthe estimated 350,000 long term survivors of childhood cancerin the United States. Individualized survivor educational resourcesare customized to the needs of each patient based on his or herdisease and its treatment.

ReferralsTo make an appointment with the Long Term Survivor Program,please call 832-822-4242. Appointments are made approximatelysix to eight weeks in advance to provide ample time for a careplan to be developed and appropriate screening appointments.Patients and families can self-refer to the Long Term SurvivorProgram directly.


Long Term Survivor Program

The Long Term Survivor Program, which currently follows approximately 1,800 long term survivors,has an international reputation as a leader in assisting pediatric cancer patients and survivors.

A multidisciplinary team of experts in pediatric oncology, surgery, pharmacology, stem cell transplant, molecular oncology,and cell and gene therapy works together to research and providenew means of diagnosing, monitoring, treating, preventing andpredicting the behavior of lymphoma.

Our mission is to develop targeted therapies and protocols forthe majority of patients using an individualized approach. Whilewe participate in Children’s Oncology Group (COG) trials, wealso assist patients who do not qualify for these trials. Ultimately,we want to design ways to minimize side effects from treatmentso that children can have healthier lives.

Some of the many conditions we treat include:

• Anaplastic large cell lymphoma• Auto-immune lymphoproliferative disease• B cell lymphomas including diffuse large B cell lymphoma• Burkitt’s lymphoma• Chronic active EBV• Epstein-Barr virus-related lymphoma and

lymphoproliferative disorders• Hodgkin’s lymphoma (Hodgkin’s disease)• Lymphadenopathy (enlarged lymph nodes)• T cell and NK/T cell lymphomas

Clinical trialsThe Lymphoma Program conducts numerous clinical trials for children with newly diagnosed lymphomas and for children withrecurrent or resistant lymphoma.

ResearchThe Lymphoma Program is dedicated to the integration of

laboratory and clinical research to increase our understandingof lymphoma and to develop new, more effective therapies forthese conditions. The principal areas of research focus on understanding the genetic determinants of tumor biology, exploitingthe relationship of lymphoma with the immune system to developimmunotherapy and developing new drugs.We are part of a National Cancer Institute-funded Specialized Programs of ResearchExcellence grant and participate in COG and internal lymphomastudies within Texas Children’s Cancer Center and the Cell andGene Therapy Program.

ReferralsPhysicians and families may call the Lymphoma Program at 832-822-4242 or 1-800-226-2379.


Lymphoma Program

As the only stand-alone pediatric lymphoma program in the country, the Lymphoma Program atTexas Children’s Cancer Center offers unparalleled care, access to clinical trials and innovativetherapies for children with lymphoma and lymphoproliferative disorders.

Our multidisciplinary team includes dedicated physicians, nursesand research coordinators who focus solely on neuroblastoma.We work closely with our Surgical Oncology Group (all ofwhom are neuroblastoma researchers), the Solid TumorProgram, the Pathology Section, the Center for Cell and GeneTherapy (Bone Marrow Transplant and Immunotherapy researchgroup) and a wealth of social support services provided by Texas Children’s Hospital.

TreatmentNeuroblastoma is one of the most common solid tumors inchildren, and approximately 700 patients are diagnosed eachyear in the United States.We care for patients of all ages diagnosed with neuroblastic lesions, from benign masses tohighly aggressive, malignant tumors.

Our program is focused not only on methods to improve ourcurrent care platform, but also to incorporate additional non-toxictreatment options to improve cure rates. Our comprehensivetreatment options include surgery, radiation therapy, high-dosechemotherapy with stem cell rescue and immunotherapy withantibody,T cells and/or vaccines.

ResearchNeuroblastoma remains a therapeutic challenge and there is anurgent need for additional research to develop more effectiveand less toxic treatment options for children with this disease.

Clinically, our program offers novel treatment options includingInvestigational New Drug trials, Children’s Oncology Groupstudies and local pilot clinical studies. Over the past decade, ourtranslational program has become nationally recognized for thedevelopment and use of immunotherapy in patients with relapsedor refractory disease.We recently completed and published the largest trial using chimeric antigen receptor T cells designedspecifically for children with neuroblastoma.

We recognize that standard treatment options will not work for all children.Therefore, we are actively investigating new sequencing and genomic approaches to better characterize neuroblastoma tumors.

ReferralsPhysicians and families may call the Neuroblastoma Program at832-822-4242 or 1-800-226-2379.


Neuroblastoma Program

Founded in 2007, the Neuroblastoma Program at Texas Children’s Hospital has grown to becomeone of the top referral centers in the country for treating this condition.

Palliative care is an area of medicine that focuses on reducingsuffering and improving quality of life for people with life-threatening illnesses. Palliative care focuses not only on the patient’s physical symptoms but also on psychological, emotionaland social distress.

Texas Children’s Cancer and Hematology Centers’ PalliativeCare Team includes board-certified physicians, nurse practitionersand others who help patients feel more comfortable and improvetheir quality of life. The team addresses symptoms such as pain,fatigue and nausea as well as feelings like anxiety or depression.Palliative care can be integrated into any phase of treatment andhas positive physical and emotional benefits for patients and families.

At Texas Children’s Cancer and Hematology Centers, we encourage patients and families to talk to caregivers about palliative care. Our commitment to the whole child and familystarts at the time of diagnosis and continues throughout treatmentand beyond.

ReferralsFor more information on palliative care, please call 832-824-4588or 832-822-1317.


Palliative Care Program

With physicians specifically board-certified in palliative care, our program addresses the psychological, emotional and social challenges of cancer on an entire family.


Precision OncologyConsultation Service

Pediatric cancer researchers have learned that each child’s tumoris unique, with different underlying genetic mutations and sequences.Investigators at Texas Children’s Cancer Center are leading cutting-edge studies to understand how genome sequencing can beused to identify these mutations and implement more precisely-targeted, patient-specific treatments to improve outcomes foreach childhood cancer patient. Now they are also incorporatingthese technologies into the pediatric cancer clinic.

The clinical Precision Oncology Consultation Service will usestate-of-the-art genomic testing to comprehensively analyze patient tumor samples and make the most informed decisionspossible for the care of each child evaluated and treated at TexasChildren’s Cancer Center. In addition, the Precision Oncologyteam will be available to help interpret results of testing performedoutside of Texas Children’s and to advise families (and their oncologists) about what sequencing tests, if any, might be themost useful for their child’s cancer care.

Texas Children’s Cancer Center is a leader in the use of precisiononcology strategies for the care of children with rare, relapsed,refractory and high-risk cancers – patients with limited treatmentoptions who are most in need of novel therapeutic approaches.

Our TeamThe multidisciplinary precision oncology team includes expertsin personalized medicine including oncologists, pathologists, surgeons and geneticists who work together to identify the besttreatment and clinical trial options for each individual patient.Importantly, this team has expertise in the genetics and treatmentof each type of childhood cancer and extensive experience withthe development and evaluation of innovative new cancer therapies.

Contact UsPhysicians and families may contact the Precision OncologyConsultation Service by calling 1-800-226-2379 or emailing [email protected].

One of the only centers in the United States providing individualized care for pediatric patientswith relapsed, refractory and high-risk cancers by analyzing patient tumor samples with state-of-the-art genomic sequencing.


Rare Tumors Program

As part of the largest pediatric cancer center in the United States,Texas Children’s Rare Tumors Program cares for a substantialnumber of children with rare tumors. Our multidisciplinaryteam of pediatric oncologists, pathologists, surgeons, radiologists,geneticists and researchers work together to achieve the bestoutcome for every patient.

TreatmentRare tumors in children range from cancers that occur only during childhood, such as pleuropulmonary blastoma, to cancersthat primarily occur in adults but can rarely occur in children,such as melanoma and colorectal cancer. Often, no standard diagnostic or treatment protocols exist for rare childhoodtumors. We have developed standardized treatment regimensfor multiple rare childhood tumors, and, when applicable, we use advanced molecular diagnostic techniques to facilitate timely and accurate diagnoses.

ResearchOur research is focused on understanding the genetic basis of raretumors and identifying novel treatment targets. We collaboratewith other pediatric cancer programs, both nationally and internationally, to improve the diagnosis and treatment of raretumors. We also actively participate in national registries for individual tumors and are developing registries for tumors thatdo not have a dedicated registry.

ReferralsPhysicians may make referrals or inquire about second opinions bycalling 832-822-4242 or 1-800-226-2379. They may also email usat [email protected]. Families may contact us at 832-822-1564.

The only pediatric rare tumors program in the southwestern United States, providing care andnew treatment options to children and adolescents with rare malignancies.

The Retinoblastoma Center of Houston is a consortium ofphysicians and scientists from some of the premier medical institutions in Houston:Texas Children’s Cancer Center andBaylor College of Medicine, the Children’s Cancer Hospital atThe University of Texas and MD Anderson Cancer Center andThe Methodist Hospital.We provide comprehensive treatmentfor children with retinoblastoma, education for patients, families and the medical community and cutting-edge basic

and clinical research.

As the only center of its kind in the southwestern UnitedStates, patients are provided the highest quality of care for theircondition. Our team includes specialists in pediatric oncology, ophthalmology, radiation therapy, cell and gene therapy, ocularpathology and cancer genetics. We offer counseling, psychosocialsupport and a wealth of other services for patients and families.

TreatmentOur multidisciplinary approach results in an individualized treatment plan for each patient.We perform genetic testing ontumor tissue and peripheral blood in all patients who undergoenucleation, and we offer appropriate genetic counseling once wehave the testing results.

Depending on the kind and stage of retinoblastoma, theRetinoblastoma Center of Houston offers treatment using

ophthalmic surgery, cryosurgery, photocoagulation, proton beam radiation therapy, intrathecal chemotherapy and systemicchemotherapy with or without autologous bone marrow transplantfor patients whose disease has spread beyond the eye to otherparts of the body.The goal is to use the least invasive treatmentnecessary to save the child’s life, eye and vision.

ResearchAt Texas Children’s Cancer Center, retinoblastoma research iscurrently focused on ocular gene therapy.The Ocular GeneTherapy Group is investigating various gene transfer approachesto treat and prevent eye diseases. It has also developed a novelapproach to treating retinoblastoma with the ultimate goal notonly of curing the disease, but also saving vision.We are alsostudying the mechanisms that spread the disease beyond the eye in children with retinoblastoma with the goal of developingtreatments for this debilitating complication of the disease.

ReferralsPhysicians and families may call the Retinoblastoma Center ofHouston at 877-730-3927 or 1-800-226-2379.


The Retinoblastoma Center of Houston

The Retinoblastoma Center of Houston provides multidisciplinary care and innovative treatmentfor children from around the world.

Our individualized course of treatment includes patient care, education, psychosocial support services, screening and counselingfor children and their families. Serving over 1,000 children eachyear, our program is one of the largest in Texas.The Sickle Cell Center offers the latest treatments including hydroxyurea,transfusions and stem cell transplantation.

Multidisciplinary careOur multidisciplinary team is made up of board-certified pediatrichematologists, hematology-trained nurse practitioners andphysician assistants, research staff and social workers. In addition,we offer psychological support and counseling services to helpfamilies cope with difficult social, emotional and financial issuesbrought on by the disease’s medical complications, especially debilitating pain crises.Texas Children’s Sickle Cell Center offersexcellent ambulatory services, including outpatient blood transfusion and pain treatment programs, a sickle cell pulmonaryclinic, sickle cell stroke clinic and genetic counseling, all in one location.

When it’s time for patients to transition to adult sickle cell care,we continue to provide support through our affiliation with Baylor College of Medicine.

ResearchThe Sickle Cell Center conducts state-of-the-art clinical and laboratory research aimed at gaining a better understanding ofthe disease, preventing its complications and ultimately finding acure.The center’s research funding is provided by governmentgrants and the philanthropic support of a variety of community-based organizations. Children receiving care at Texas Children’sSickle Cell Center have the opportunity to participate in several

National Institutes of Health-funded research studies led byphysician scientists, providing the latest treatments for this disease.This partnership allows us to offer even more noveltherapies to our sickle cell patients.

ReferralsPhysicians and families may call the Sickle Cell Center at 832-822-4362 or 1-855-824-2972.


Sickle Cell Center

The Sickle Cell Center at Texas Children’s Hematology Center offers comprehensive family-centered care for children with this complex blood disorder.

Our program provides a multidisciplinary team of experts who collaborate in the care of each patient and in the developmentand execution of cutting-edge clinical trials to improve outcomesfor these patients. We treat patients with a wide variety of solidtumors and cancers, including:

• Ewing sarcoma• Germ cell tumor• Kidney tumors• Liver tumor• Melanoma

Our physicians have extensive expertise in the treatment of raretumors such as hepatoblastoma and hepatocellular carcinoma(liver tumors), germ cell tumors (tumors of the reproductive organs), sarcomas of the soft tissues and many other cancers. Inaddition, the Solid Tumor Program has a special interest in thestudy of vascular tumors (hemangiomas, vascular malformationsand malignancies). Seeing over 150 new patients a year, we areone of the largest pediatric solid tumor programs in the country.

ResearchOur investigators play leadership roles at the national levelthrough participation in the solid tumor clinical research effortsof the National Cancer Institute-sponsored Children’s OncologyGroup. We use translational research to initiate clinical trials.Examples of these include promising phase I vaccine trials in themanagement of neuroblastoma and engineered T cell therapyfor osteosarcoma. Our comprehensive program also focuses

on the genetic composition of osteosarcoma and potential ofosteosarcoma cells to spread to distant organs. We are alsoexamining how genome sequencing can eventually lead to betteroutcomes for children with solid tumors.

ReferralsPhysicians and families may call the Solid Tumor Program at832-822-4242 or 1-800-226-2379.


Solid Tumor Program

The Solid Tumor Program at Texas Children’s Cancer Center provides cutting-edge clinical carefor children with tumors of the bone, soft tissue, kidney, liver and other organs.

• Neuroblastoma

• Osteosarcoma• Rhabdomyosarcoma• Thyroid tumor


Thyroid Cancer Program

There are three main types of thyroid cancer: Papillary, Follicularand Medullary. Children who are at increased risk for thyroidcancer include:

• Childhood cancer survivors who received radiation therapyto the neck as part of their initial treatment

• Children with Hashimoto Thyroiditis • Children with Gardner's Syndrome, MEN 2A or 2B

Evaluation and Treatment Cancer of the thyroid gland often presents as a swelling in front ofthe neck. Sometimes, patients can present with difficulty swallowingor enlargement of lymph glands in the neck. At Texas Children’sCancer and Hematology Centers, children are initially evaluatedusing ultrasound examination and laboratory tests. When indicated,we perform a fine needle aspiration of the suspicious thyroidswelling and confirm the diagnosis of thyroid cancer using thelatest molecular diagnostic testing. Thyroid cancer in children isgenerally treated with surgery and radioactive iodine. For childrenrefractory to these modalities, we are able to offer medical therapyusing targeted agents.

Our team of experts includes pediatric oncologists, surgeons, endocrinologists, pathologists, radiologists, cancer geneticists,pediatric nurses, social workers and child life specialists. Thisteam approach enables patients and families to receive the most

comprehensive and innovative care in a single location over thefull course of their treatment and for long term follow-up care.

Research and Clinical TrialsIn order to understand the biology of thyroid cancer, with the goalof offering more successful therapies for pediatric patients, we haveestablished the North American Pediatric Thyroid Cancer registryto collect information on children with thyroid cancers. You canemail [email protected] to get information on how to enroll in the registry.

We are the first and only center in North America to open aclinical trial of Lenvatinib in children, a drug currently approved foruse in adults. We are currently testing the safety and efficacy of thismedication in children with thyroid cancers. More informationon this clinical trial can be obtained by [email protected] or visiting clinicaltrials.gov.

ReferralsPhysicians and families may make referrals by calling the Rare Tumors Program at 832-822-4242 or 1-800-226-2379. They may also email us at [email protected]. We welcome oncologists to contact us for second opinion consultationsabout the care and management of individual patients.

Each year approximately 1,000 children and adolescents are diagnosed with thyroid cancer in the United States. The Thyroid Cancer Program at Texas Children’s Cancer Center offersmultidisciplinary care to patients with thyroid cancer.


Vascular Anomalies Program

Vascular tumors managed in the Vascular Anomalies Program include:

• Kaposiform Hemangioendothelioma (KHE)• Hepatic Angiosarcoma• Epitheloid Hemangioendothelioma• Hepatic Hemangiomas (congenital and infantile)

Vascular malformations managed in the Vascular Anomalies

Program include:

• Capillary-Venous-Lymphatic Malformation (Klippel-Trenaunay Syndrome)

• CLOVES Syndrome• Blue Rubber Bleb Nevus Malformations• Parkes-Weber Syndrome• PTEN Hamartoma Tumor Syndrome• Hereditary Hemorrhagic Telangiectasia• Generalized Lymphatic Anomaly• Gorham-Stout Disease

The complete team includes expert pediatric hematology-oncology specialists, physical therapists, a nutritionist, woundcare specialists, social workers and child life specialists whowork together to cover all aspects of comprehensive managementin the context of the most advanced medical therapies.

We initiate or participate in almost all national clinical trials dedicated to vascular anomalies. Treatment is available either aspart of a clinical trial or as standard of care, ranging from intensesupportive medical care to anticoagulants, sirolimus (Rapamycin),thalidomide or chemotherapy.

TreatmentTexas Children’s Hospital has experts in all pediatric subspecialtiesinvolved in the treatment of vascular anomalies. The medical teamworks closely with Interventional Radiology, Plastic Surgery,Dermatology, Otolaryngology (Ear, Nose and Throat), PulmonaryMedicine, Liver Transplant, Gastroenterology, Hepatology and Nutrition, and more, to provide integration of care, peri-procedural supportive management and a unified treatmentplan for the patients.

The whole spectrum of advanced surgical interventions, endovascular procedures (sclerotherapy) and laser therapy areavailable at Texas Children’s Hospital. We provide inpatient andoutpatient services at two Texas Children’s Hospital locations:Main Campus and West Campus.

ReferralsPhysicians and families may contact the Vascular Anomalies Program at 832-822-4242 or 1-800-226-2379.

The Vascular Anomalies Program at Texas Children’s Cancer and Hematology Centers specializes inproviding comprehensive management of vascular tumors and malformations in pediatric patients.

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